HealthDay News — Laypersons’ ability to identify facial paralysis increases with the severity of the condition, although individuals are not always able to accurately localize paralysis on the face, according to a study published online in JAMA Facial Plastic Surgery.

Peiyi Su, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted a prospective observational study to assess societal members’ ability to identify facial paralysis of varying degrees and localize the defect on the face. Web-based surveys were designed showing smiling and repose images of normal faces as well as faces with unilateral facial paralysis in 3 levels of severity. These images were shown to 380 casual observers who viewed 2860 facial photographs in aggregate.

The researchers found that participants correctly identified facial paralysis in 34.6% of the 719 photographs with low-grade paralysis, 63.2% of the 709 photographs with medium-grade paralysis, and 96.7% of the 720 photographs with high-grade paralysis. Paralysis was incorrectly identified in 6.2% of the 731 normal faces. Study participants correctly localized facial paralysis in 63% of 249 low-grade photographs, 68.5% of 448 medium-grade photographs, and 79.6% of 696 high-grade photographs. In general, facial paralysis was more accurately identified in smiling vs repose faces.

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“These findings are important in the future counseling of patients,” the authors write.

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Su P, Ishii LE, Nellis J, et al. Societal identification of facial paralysis and paralysis location [published online February 8, 2018]. JAMA Facial Plast Surg. doi:10.1001/jamafacial.2017.2402